Effects of a Case Management Program on Self-Care Behaviors and Diabetic Retinopathy Clinical Signs among Elderly with Diabetic Retinopathy in Quality Elderly Clinic
Keywords:
Case management, Elderly, Diabetic retinopathy, Self-care behaviorAbstract
Effects of a Case Management Program on Self-Care Behaviors and Diabetic Retinopathy Clinical Signs among Elderly with Diabetic Retinopathy in Quality Elderly Clinic ABSTRACT : Diabetic retinopathy is a common complication of Diabetes Mellitus (DM), leading to blindness and impacts on quality of life of patients and families. This one-group, quasi-experimental study was conducted to examine the effects of a case management program applying Orem’s nursing system theory and social support for older people with diabetic retinopathy. Thirty subjects were participated in a 12-week case management program, which applied Orem’s nursing system theory. The program consisted of health education, health assessment, a clinical pathway, individual counseling, a home visit, telephone follow up, with assessment of self-care behavior. Hemoglobin A1C (HbA1C) levels, fasting plasma glucose (FPG) and blood pressure were assessed before and after the program. Each subject was interviewed by the researcher about general characteristics, self-care behaviors. Data were analyzed using paired t-test. After the intervention, the mean scores of self-care behaviors of the older people with diabetic retinopathy were significantly higher than those before the experiment at a p-value of< 0.001. FPG, Hemoglobin A1C (HbA1C) and systolic blood pressure were significantly lower than before the intervention at a p-value of < 0.001. Moreover, diabetic retinopathy was not worse 96.6%. The results support a case management program applying Orem’s nursing system theory and social support that improved self-care behaviors and those clinical signs. This intervention should be applied in Quality Elderly care clinic to promote health outcomes among elderly with other chronic diseases.
References
2. Royal College, Department of Medicine ,Diabetes Association of Thailand. Clinical Practice Guideline for Diabetes 2017. (in Thai)
3. Public Health center Chonburi province. Data of HDC Program: screening for diabetic retinopathy, 2017. (in Thai)
4. Diabetes Control and Complications Tral/Epidemiology of Diabetes Interventions and Complications Research Group. Retionpathy and nephropathy in patients with type1 diabetes four years after a trai of intensive therapy. N Engl J Med 2000; 342:381-9.
5. Stratton I M, Adler A I, Neil H A, Neil HAW, Matthews DR. Long-term follow-up after tight control of blood pressure in type 2 diabetes. N Engl J Med 2008; 359:1565-76.
6. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol 1985;103:1796-806.
7 Suksripaisarn P .Screening for diabetic retinopathy in diabetic patients by non mydriatic fundus camera in Ayutthaya Province. Thammasat Thai Journal of Ophthalmology 2010; 5(2) : 31-7 (in Thai)
8. Schoenfeld E R, Greene J, Wu S Y, Leske M C. Patterns of adherence to diabetes vision care guidelines: baseline findings from the diabetic retinopathy awareness program. Ophthalmology 2001; 108(3):563-751.
9. Kanglee K. Factors associated with glycemic control among people with type2 diabetes mellitus at Phramongkut Klao hospital, Bangkok. Journal of The Royal Thai Army Nurses 2014;15(3).256-267 (in Thai)
10. Sarinnaphakorn V. Management difficult cases of DM. Department of Internal Medical Rajavithi Hospital.2014. (in Thai)
11. CIC, MacColl Institute for Healthcare Innovation. Chronic Care Model. Innovation.
12. Orem D E, Susan G,Taylor & Kathie M L. Renpenning Nursing concepts of practice (6thed.). St. Louis, Mosby. 2001
13. Thanomboon T, Chanda-nasothi P, Amnatsatsue K, Kerdmongkol P, The Application of Orem theory with management for prevention recurrent hypoglycemia in elderly. Journal of Public Health Nursing2012; 26(3):94-105 (in Thai)
14. Suttai P, Chaiyong K, Atiporn T. Effects of self-efficacy theory and social support for diabetes type II control of the Elderly in Swai Sub District, Muang District, Surin Province. Primary Health Care Division Journal 2011; 7(1): 8-19 (in Thai)
15. James S H, Debra U, Karl R L. Structures and Processes of Social Sopport. Annual Review of Sociology 1988; August Vol.14, 293-318.
16. Powell S K & Tahan H A. Case management: a pratical guide for education and pratice. (3rded.). 10 Journal of Public Health Nursing May–August 2017 Vol. 31 No.2 Philadelphai, PA; Wolters Kluwer Health Lippincott William &Wikins.2010.
17. Sindhu S, Wongrod P,editors. Case management for clients with diabetic mellitus and hypertension 2nded. Bangkok: Wattanakanpim Printing 2014 (in Thai)
18. Polit D F and Hungler B P. Nursing research: principles and methods. 6thed. Philadephia: Lippincott 1999.
19. Muksiritipanun B, Monthaisong D, Factors related to quality of life in patients with diabetic retinopathy. Journal of The Royal Thai Army Nurses 2014; 15(2): 395-404 (in Thai)
20. Phosritong W, Maneesilp T, Podhipak P, Chonbodeechalermrung N. The development of diabetes care system: a case management model at Saraburi Hospital. Journal of Nursing Division 2012; 5(2),79-93 (in Thai).
21. Mettapracharak hospital. Primary Eye disease Care. Petkasam printihg group company Nakonpratom, 2015. (in Thai)
22. Rattanasila R, Amnatsatsue K, Chansirikarna S, Klunklin S, Kedmongkol P, Effect of care management program for older adults with uncontrolled. Journal of Public Health Nursing 2015; 29(1):67-79 (in Thai)
23. Kerdmongkol P, Amnatsatsue K, Rattanasoungthum P. Effect of a case management program for older people with diabetic retinopathy. Journal of Public Health Nursing 2017; 31(2): 1-10 (in Thai)
24. Tongpeth J. Effectiveness of self-management promoting potential program on blood sugar control and quality of life among diabetes mellitus type 2 patients. Journal of The Royal Thai Army Nurses 2013; 14(2). 69-78 (in Thai)
25. Panlamlert K. Effects of self-management program on HbA1C and Blood Pressure level of diabetic retinopathy. (Thesis Master of Nursing Science). Bankok; Chulalongkorn University. 2009 (in Thai)
Downloads
Published
How to Cite
Issue
Section
License
บทความหรือข้อคิดเห็นใดใดที่ปรากฏในวารสารพยาบาลทหารบกเป็นวรรณกรรมของผู้เขียน ซึ่งบรรณาธิการหรือสมาคมพยาบาลทหารบก ไม่จำเป็นต้องเห็นด้วย
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารพยาบาลทหารบก
The ideas and opinions expressed in the Journal of The Royal Thai Army Nurses are those of the authors and not necessarily those
of the editor or Royal Thai Army Nurses Association.
